LTSS Transition & Care Navigator (Field-Based)

Humana; Illinois; On-site; USD 59,000 - 81,000; Full time

Job summary

Humana seeks a Transition/Custodial Prevention Specialist to work in the Illinois region, meeting members in homes or facilities to develop care plans and connect with community services. The role emphasizes LTSS, HRSNs, and person-centered planning with a focus on independence.

The position requires travel within the region, collaboration with care teams, and expertise in HCBS, Medicaid eligibility, and community resources. Eligible for a bonus plan; field-based with 40-hour work weeks.

Qualifications

• Residency in Illinois.
• Bachelor's degree in social sciences, social work, human services, or related field.
• Two years of experience with Medicare/Medicaid recipients, LTSS, HCBS, or managed care.
• One+ year of experience with custodial and transitional care.
• Experience with electronic medical records.
• Ability to travel regionally to meet members and families.

Responsibilities

• Provide LTSS support focusing on health-related social needs (HRSNs) and ensuring LTSS meets member service needs.
• Build relationships with facility staff, advocate for member care, and assess the ability to return to the community.
• Contact members to set goals, evaluate resources, develop plans of care, and identify LTSS providers.
• Work with an interdisciplinary team to access long term services and supports across social, housing, education and other services.
• Develop and modify Individual Service Plans with care team involvement (informal caregiver coach, PCP, etc.).
• Support members in navigating LTSS and related environmental and social needs.
• Avoid duplicative assessments by utilizing available information.
• Recommend Home and Community-Based Services to promote independence.
• Facilitate interactions with payers, providers, and care teams.
• Educate members on maintaining Medicaid eligibility.
• Assist with annual Level of Care assessments in the state portal.

Skills

Travel ability

Interdisciplinary collaboration

Education

Bachelor's degree in social sciences / social work / human services

Licensed professional counselor (LPC) / licensed social worker (LSW) / registered nurse (RN) in IL

Tools

Electronic Medical Records

Electronic information systems

Job description

Humana seeks a Transition/Custodial Prevention Specialist to work in the Illinois region, meeting members in homes or facilities to develop care plans and connect with community services. The role emphasizes LTSS, HRSNs, and person-centered planning with a focus on independence.

The position requires travel within the region, collaboration with care teams, and expertise in HCBS, Medicaid eligibility, and community resources. Eligible for a bonus plan; field-based with 40-hour work weeks.